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Textbook Outcomes of Right Hemihepatectomy in Patients With Hepatocellular Carcinoma

Recruiting
Conditions
Hepatocellular Carcinoma
Hepatectomy
Laparoscopic Hepatectomy
Registration Number
NCT06950827
Lead Sponsor
West China Hospital
Brief Summary

Although traditional open right hemihepatectomy is a mature technique, the incision is usually very large; Intraoperative bleeding may be excessive, and postoperative liver failure is also prone to occur. In recent years, compared with traditional open surgery, laparoscopic surgery has many advantages, such as smaller surgical incision and faster postoperative recovery. In recent years, more and more centers have gradually transitioned to performing right hemihepatectomy through laparoscopy as much as possible. However, due to the difficulty of the surgery, steep learning curve, and postoperative complications, its adoption is limited to high-capacity surgical centers. Despite significant progress in laparoscopic liver resection technology, its clinical efficacy remains controversial, especially in laparoscopic right hemihepatectomy. More research is needed to confirm the feasibility and safety of this surgery. At present, it is unclear whether there is a difference in textbook outcomes (TO) between HCC patients undergoing open and laparoscopic right hemihepatectomy, and the association between TO and patient survival prognosis.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
400
Inclusion Criteria
  1. Age ≥ 18 years old;
  2. The lesion is limited to the right half of the liver and diagnosed as hepatocellular carcinoma based on paraffin pathology and immunohistochemistry results;
  3. The type of surgery is elective surgery;
  4. The patient's preoperative liver function was Child Pugh A or B grade, and the preoperative ASA (American Society of Anesthesiologists) rating was I, II, or III.
Exclusion Criteria
  1. Pathological confirmed cholangiocarcinoma, mixed cell carcinoma, or extrahepatic metastatic malignant tumors;
  2. Previous history of upper abdominal surgery;
  3. Simultaneously undergoing adjacent abdominal organ resection, major vessel and biliary reconstruction surgery, except for the gallbladder;
  4. Merge adjacent organ invasions except for the gallbladder, with main blood vessels, bile duct cancer emboli, or distant metastases;
  5. Lost to follow-up or loss of primary clinical data.

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Textbook outcomeFrom January 2018 to January 2023

Textbook outcome (TO) was defined as the absence of intraoperative grade ≥ 2 incidents (defined according to the Oslo classification), postoperative bile leak of grade B or C (according to the severity grading of the International Study Group of Liver Surgery), postoperative liver failure grade B or C (according to the severity grading of the International Study Group of Liver Surgery), major postoperative complications within 90 days (Clavien-Dindo grade III or higher), readmission within 90 days after discharge due to surgery related major complications (Clavien-dindo Grade III or higher), in-hospital or 90-day mortality and the presence of R0 resection margin (i.e. 1mm or more tumor free margin).

Secondary Outcome Measures
NameTimeMethod
Overall survivalFrom January 2018 to January 2023

Overall survival (OS) was defined as the interval from liver resection to death or the last follow-up.

Disease-free survivalFrom January 2018 to January 2023

Disease-free survival (DFS) was defined as the time from liver resection to disease recurrence or death from any cause.

Trial Locations

Locations (1)

West China Hospital

🇨🇳

Chengdu, Sichuan, China

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